单髁置换术后膝关节内外侧间室应力变化有限元分析

目的:采用有限元分析方法研究单髁置换术后膝关节表面应力变化,为深入了解单髁置换术优势及劣势提供依据。方法:对6例单髁置换术后及6例正常人膝关节屈伸活动时关节表面应力变化进行动态有限元分析,并与项目组前期全膝关节置换术后关节表面应力分析进行对比。结果:正常组屈曲30°以后内侧间室应力大于外侧间室(P<0.05);单髁置换组屈曲0°、60°、90°时内侧间室应力大于外侧间室(P<0.05);全膝置换组在所有屈曲角度下内侧间室应力大于外侧间室(P<0.05)。屈曲60°及90°时单髁置换组内侧间室应力大于全膝置换组(P<0.05);所有屈曲角度下,单髁置换组外侧间室应力大于全膝置换组外侧间室应力(P<0.05);屈曲0°、30°、60°及120°时,单髁置换组外侧间室应力都大于正常膝组(P<0.05)。结论:单髁置换术可增加膝关节关节面应力及加速对侧间室关节炎发展,从而影响手术远期疗效,但在严格把握手术适应症、优化手术操作、假体适当改良、指导患者合理康复后,该术式仍具有优势。     

全膝关节置换术与膝关节单髁术置换患者住院费用构成比较

目的比较3年内行全膝关节置换术及膝关节单髁置换术住院患者的住院费用结构比例,分析两种手术方式的疗效和住院费用的差异。方法收集北京积水潭医院矫形骨科自2013年3月至2016年6月间行全膝关节置换术及膝关节单髁置换术的3 096例患者的临床资料和具体住院费用,对住院费用结构进行统计分析。结果行膝关节单髁置换患者的人均总费用、卫生材料费、手术费、药费、治疗费、麻醉费、床位费、检查费、输血费以及平均住院日,均显著低于行全膝关节置换术患者。两种术式膝关节评分和活动度均较术前有显著性提高。结论全膝关节置换及膝关节单髁置换是治疗终末期膝关节骨关节炎的主要手术方式。合理选择手术方式有助于控制围手术期医疗费用,减轻患者经济负担。     

膝关节单髁置换术患者围术期护理体会

单髁置换和全膝关节置换术已广泛应用于严重膝关节骨关节炎。膝关节单髁置换（Unicondylar knee arthroplasty,UKA）作为一种微创关节置换手术越来越为患者和医师所接受,它具有切除骨质少、植入异物少、手术时间短、便于翻修、步态影响小。我科自2005年1月．2006年5月施行单髁置换术8例,术后随访2．10月,关节疼痛改善．步态正常,疗效满意,患者生活质量明显提高。     

SuperPath全髋置换与全髋关节置换术的近期疗效对比分析

目的对比分析SuperPath全髋置换与全髋关节置换术的近期疗效。方法回顾性分析2015年12月—2016年12月新沂市中医医院骨伤科行全髋关节置换的60例患者临床资料,其中男性39例,女性21例;年龄40～75岁,平均58.6岁。按照手术方式分组,常规全髋关节置换术30例(常规切口组),SuperPath全髋置换30例(SuperPath组)。观察统计两组的术中出血量、术后3、7d VAS评分、临床疗效、早期恢复时间及Harris评分并进行比较。结果 SuperPath组术中出血量显著少于常规切口组[(350.12±41.12)mL vs.(470.15±60.24)mL],术后3、7d分别SuperPath组VAS评分均低于常规切口组[(5.35±1.01)分vs.(5.25±1.02)分、(3.25±2.12)分vs.(1.02±0.11)分];SuperPath组术后首次下床行走时间、脱拐行走时间、住院时间显著低于常规切口组;与术前比较,两组患者术后不同时间的Harris评分、均显著提高,且术后不同时间组间比较SuperPath组Harris评分均显著高于常规切口组(P<0.05)。结论与常规全髋关节置换术进行比较,对患者行SuperPath全髋置换治疗效果更好,可以显著减轻患者的疼痛程度,改善其髋关节功能,提高近期疗效。     

人工全髋关节置换和双极股骨头置换治疗老年股骨颈骨折疗效观察

目的：观察老年股骨颈骨折行人工全髋关节置换和双极股骨头置换的临床疗效并进行比较。方法：2005-07-2010-01共62例65岁以上的老年股骨颈骨折患者,随机分为两组,分别行人工全髋关节置换术及双极股骨头置换术。分别对手术时间、术中失血量、术后疼痛、术后并发症、住院时间、住院费用及手术后不同时期髋关节Harris评分进行比较。结果：术后随访4.2-5.5年,平均4.8年。全髋关节置换组的手术时间、术中失血量高于双极股骨头置换组（P〈0.05）,两组的住院时间、住院费用及术后疼痛、术后并发症无明显差异,随访6、12、24个月时两组间Harris评分无差异,随访3年及4年时全髋关节置换组Harris评分优于双极股骨头置换组。结论：人工全髋关节置换及双极股骨头置换均是治疗老年股骨颈骨折的有效方法,全髋关节置换远期效果优于双极股骨头置换。     

生物型与骨水泥型假体全髋关节置换术治疗老年移位型股骨颈骨折的疗效分析

目的 比较生物型与骨水泥型假体全髋关节置换术(THA)治疗老年移位型股骨颈骨折(DFNF)的临床疗效.方法 前瞻性纳入2015年7月—2018年6月佳木斯大学附属第一医院骨科收治的老年DFNF患者128例,男性71例,女性57例;年龄61～84岁,平均72.7岁.骨折原因:跌伤75例,撞伤32例,高处坠落伤21例.依据随机数字表法分为生物型假体THA组(BPTHA组,n=64)与骨水泥型假体THA组(CPTHA组,n=64).BPTHA组行生物型假体髋关节置换,CPTHA组行骨水泥型假体髋关节置换.观察两组术中出血量、手术时间、术后引流量等围术期指标及住院时间.比较术前及术后6、12个月髋关节功能(Harris),血清前列腺素缓激肽(BK)、5-羟色胺(5-HT)等疼痛因子水平及视觉模拟评分(VAS),血清淀粉样蛋白A(SAA)、C反应蛋白(CRP)、红细胞沉降率(ESR)等炎性反应指标水平;分析术后并发症发生情况.结果 两组术中出血量、手术时间、术后引流量差异均无统计学意义(P>0.05);BPTHA组住院时间长于CPTHA组[(19.76±2.24)d vs.(15.37±1.71)d,P<0.05].术后6个月,BPTHA组Harris评分低于CPTHA组[(81.72±8.37)分vs.(86.68±8.85)分,P<0.05];术后12个月,BPTHA组Harris评分高于CPTHA组[(95.54±9.67)分vs.(90.72±9.12)分,P<0.05].术后6个月,BPTHA组血清BK、5-HT、SAA、CRP、ESR水平及VAS均高于CPTHA组(P<0.05);术后12个月,BPTHA组血清BK、5-HT、SAA、CRP、ESR水平及VAS均低于CPTHA组(P<0.05).BPTHA组并发症发生率为3.13％,CPTHA组并发症发生率为4.69％,两组比较差异无统计学意义(P>0.05).结论 BPTHA、CPTHA均可应用于老年DFNF的临床治疗,但CPTHA近期疗效优于BPTHA,而BPTHA远期疗效优于CPTHA.     

侧卧位直接前路全髋关节置换治疗伴有偏瘫的股骨颈骨折的近期疗效观察

目的 观察侧卧位直接前路(direct anterior approach, DAA)人工全髋关节置换手术治疗脑血管意外患者偏瘫侧股骨颈骨折的近期疗效。方法 回顾性分析亳州市人民医院骨科2018年1月—2020年8月收治的因脑血管意外而致偏瘫侧肢体发生股骨颈骨折的患者57例，按入院后不同治疗分为DAA组和后外侧入路组。DAA组29例采用侧卧位DAA人工全髋关节置换手术治疗，男性15例，女性14例；年龄57～70岁，平均68.3岁；道路交通伤9例，摔伤15例，高处坠落伤5例。后外侧入路组28例采用常规后外侧入路人工全髋关节置换手术，男性14例，女性14例；年龄63～69岁，平均66.6岁；道路交通伤9例，摔伤14例，高处坠落伤5例。观察记录两组患者伤口长度、手术时间、术中失血量、住院时间，术后3、7d疼痛视觉模拟评分(visual analogue scale, VAS),术前及术后1、3、6、16个月随访时髋关节功能评分、手术并发症等，评定侧卧位DAA入路髋关节置换对偏瘫侧肢体股骨颈骨折治疗的安全性和有效性。结果 患者均顺利完成手术，DAA组较后外侧入路组切口长度短[(9.32±2.2...     

双动全髋关节置换治疗移位性股骨颈骨折的疗效分析

目的分析双动全髋关节置换治疗移位性股骨颈骨折的疗效观察。方法濮阳市人民医院2015年2月—2017年2月收治的移位性股骨颈骨折的老年患者36例作为研究对象,按随机数字表法分为试验组(采取双动全髋关节置换治疗)和对照组(采取传统全髋关节置换治疗)各18例,观察两组患者手术时间、术中出血量、术后下床时间及围手术期并发症发生情况。结果 (1)试验组手术时间低于对照组[(65.1±13.2)min vs.(76.5±18.4)min],术中出血量低于对照组[(339.2±14.6)min vs.(440.1±23.8)min],下床时间低于对照组[(3.1±1.5)d vs.(4.6±2.4)d],两组比较差异有统计学意义(P0.01);(2)术后两组患者髋关节功能均恢复较好;试验组术后1、3、6、9、12个月Harris评分均高于对照组,分别为[(49.9±10.1)分vs.(38.4±5.3)分、(79.3±13.5)分vs.(68.9±8.7)分、(89.6±11.8)分vs.(82.4±5.1)分、(92.5±9.6)分vs.(84.6±6.3)分、(94.7±5.3)分vs.(87.2±3.5)分],两组比较差异有统计学意义(P0.05);(3)试验组术后12个月时健康生活质量优于对照组,两组比较差异有统计学意义(P0.05)。结论与传统全髋关节置换相比,双动全髋关节置换治疗移位性股骨颈骨折,能显著改善患者术后恢复情况,并能更好地提高患者的生活质量,值得临床上推广应用。     

两种方法治疗老年股骨颈骨折疗效比较分析

目的比较老年股骨颈骨折行人工股骨头置换术与全髋关节置换术的临床疗效。方法将82例老年股骨颈骨折患者分成两组,A组52例,采用人工股骨头置换,B组30例,采用全髋关节置换。随访6年,按Harris评分标准评定手术疗效并将结果进行比较。结果术后1年两组疗效没有明显差别,手术4年以后B组疗效优于A组,两组差别具有显著性意义。结论老年股骨颈骨折行人工股骨头置换或全髋关节置换手术的早期临床效果基本相同,但全髋关节置换手术的后期疗效优于人工股骨头置换。     

全膝关节置换术中髌骨置换对骨性关节炎患者早期疗效及膝前痛的影响

目的：探讨全膝关节置换术中是否进行髌骨置换对骨性关节炎患者的临床疗效及术后疼痛的影响。方法笔者采用随机数字表法将骨科2011年5月～2013年7月收治的93例行人工全膝关节置换术患者分为髌骨置换组43例和未置换组50例,比较两组患者治疗前与治疗后不同时间的相关指标变化差异。结果术前髌骨置换组与非置换组的膝关节KSS（美国膝关节协会）评分、Feller评分差异不显著（ P＞0．05）;术后第3、6、12个月髌骨置换组膝关节KSS评分、Feller评分显著高于非置换组（P＜0．05）;术前髌骨置换组与非置换组的膝关节视觉模拟评分（VAS）差异不显著（P＞0．05）;术后第3、6、12个月髌骨置换组膝关节VAS评分显著低于非置换组（P＜0．05）;两组患者术前、术后的胫股角,髌韧带比值,关节活动度ROM屈、伸值在两组间比较差异均不显著（ P＞0．05）;术后第12个月两组患者的胫股角、髌韧带比值,关节活动度ROM屈、伸值较治疗前均显著好转（ P＜0．05）。结论全膝关节置换术中进行髌骨置换对改善膝关节功能评分、髌骨评分、术后疼痛评分均有显著的效果。     

C-reactive protein (CRP) in different types of minimally invasive knee arthroplasty

Purpose

C-reactive protein (CRP) is an acute-phase biomarker responding to surgical trauma. Typically, a first peak is observed at day 2 with a reduction at day 4 and normalization 3–6 weeks after surgery. CRP is often linked to prosthetic joint infection when elevated values are present longer time after surgery. The aim of this study was to analyse the kinetics of CRP in different types of minimally invasive (MI) arthroplasty and to observe if there were significant differences in between MI total knee arthroplasty (TKA), patient-specific instruments (PSI) TKA and unicompartmental arthroplasty (UKA).

Materials and methods

Three hundred and seventy-two patients were prospectively studied with a blood test measuring CRP at day 2, 4, 21 and 42 in 3 different groups of patients: 257 MI TKA, 55 PSI TKA and 60 UKA. Mean peak values and kinetics were compared in between different groups of MI arthroplasty.

Results

There was a significant age difference in the three MI arthroplasty groups. The difference in mean age for the conventional MI TKA group of 68.8 ± 9.8 years, 58.5 ± 11.7 years for the unicompartmental group (P < 0.05) and 63.3 ± 9.6 years for the PSI group (P < 0.05) was significant. Mean CRP level, for the entire study group, on day 2 was 16.7 ± 8.8 mg/dl that gradually decreased to 13.6 ± 7.8 mg/dl on day 4. On day 21 and 42, median CRP level was 0.6 (0–20) and 0.4 (0–7) mg/dl, respectively. Peak CRP values were lower for UKA compared to TKA at day 2 (11.6 vs. 17.5 mg/dl) and day 4 (8.0 vs. 15 mg/dl), but this was not observed for PSI–assisted arthroplasty (18.9 vs. 17.5 mg/dl). There was a trend for faster CRP normalization in UKA compared to the two other groups at day 21 and at day 42 and for PSI TKA to have a lower mean level at 4 days (12.9 vs. 15 mg/dl). There was no statistical difference in the normalization rate of PSI–assisted versus MI TKA.

Conclusion

Kinetics of CRP in MI arthroplasty are identical to the published kinetics of conventional TKA. Most patients normalize CRP at 3 weeks; however, 18 % does not by 6 weeks. This is not a sign of early prosthetic joint infection. Peak values are significantly lower for UKA but not for PSI TKA.

Level of evidence

II.     

Late spontaneous haemarthrosis: an unusual complication following an unicompartmental knee arthroplasty

A man, aged 55, presented with a spontaneous haemarthrosis of his right knee, 1 year after an unicompartmental knee replacement. This case showed an atraumatic rupture of the metal marker wire of an all-polyethylene inlay tibial implant which caused a destruction of the polyethylene surface and a disseminated synovitis of the right knee. This is a rare but destructing complication following an unicompartmental knee arthroplasty.     

Rate of torque development is the primary contributor to quadriceps avoidance gait following total knee arthroplasty

BackgroundFollowing rehabilitation for total knee arthroplasty, “quadriceps avoidance gait”, defined by limited knee flexion angle excursion during walking, persists and contributes to poor long-term outcomes. Given the presence of several post-surgical impairments, identifying the contribution of multiple factors to knee flexion angle excursion is important to developing targeted interventions to improve recovery after total knee arthroplasty.Research questionsWhich outcomes continue to improve following rehabilitation for total knee arthroplasty? What are the primary contributors to impaired knee flexion angle excursion during walking following total knee arthroplasty?MethodsPeak muscle strength and rate of torque development of the quadriceps, hip abductors, and hip external rotators, five-time sit-to-stand test, Knee Injury & Osteoarthritis Outcome Score, and gait mechanics were assessed in 24 participants at three and six months post-surgery. Paired sample t-tests or Wilcoxon Signed-Rank tests were used to compare outcomes between assessments. Stepwise multiple linear regression were used to assess the contribution of each measure to knee flexion angle excursion.ResultsSignificant improvements were noted in all outcomes except hip external rotation rate of torque development, gait speed, and knee flexion angle excursion. Quadriceps rate of torque development and knee pain significantly contributed to knee flexion angle excursion at three months (Adjusted R² = 0.342), while quadriceps rate of torque development and peak hip external rotation strength significantly contributed at six months (Adjusted R² = 0.436).SignificanceWhile higher pain levels at three months and greater peak hip external rotation muscle strength at six months contribute to impaired knee flexion angle excursion, quadriceps rate of torque development was the primary contributor to knee flexion angle excursion at both three and six months after surgery. Implementing strategies to maximize quadriceps rate of torque development during rehabilitation may help to reduce quadriceps avoidance gait after total knee arthroplasty.     

Physical activity after total joint replacement: a cross-sectional survey.

OBJECTIVE: To determine the level of physical activity participants are able to perform at a minimum of 1 year after primary total hip or knee replacement. DESIGN: Cross-sectional survey. SETTING: A tertiary care arthroplasty center. PARTICIPANTS: A total of 170 primary total hip and 184 primary total knee arthroplasty patients. INTERVENTIONS: The University of California Los Angeles (UCLA) activity score was mailed to 242 primary hip and 225 primary knee arthroplasty patients. Patients were abstracted from a prospectively tabulated arthroplasty database and pre-selected for good/excellent clinical outcomes as determined by 1 year postoperative Knee Society (KSS) and Harris Hip (HHS) scores. Clinical outcomes including the Oxford Hip/Knee score were collected preoperatively, and at 6 and 12 months postoperatively. Correlations between UCLA scores, demographics, and clinical outcomes were calculated using Pearson's correlation. MAIN OUTCOME MEASUREMENTS: Harris Hip Score, Oxford Hip Score, Knee Society Score, Oxford Knee Score, and UCLA Activity Scale. RESULTS:: Postal survey response rates for hips were 70.2% (170 of 242) and 81.8% for knees (184 of 225). Mean results at postoperative year 1 include: HHS (94.8), Oxford Hip Score (16.6), KSS clinical score (95.9), KSS function score (95.0), and Oxford Knee score (18.2). For both primary total hip arthroplasty and total knee arthroplasty patients, median UCLA score was 6, indicating moderate activity levels at a mean follow-up of 40.7 months for hips and 36.6 months for knees. CONCLUSIONS: UCLA scores indicate the average total joint replacement patient maintains a moderate activity level, and many perform active/very active levels of activity.     

髋关节置换术后异位骨化的蛋白质组研究

目的使用蛋白质组方法,通过比较髋关节置换术后并发异位骨化与未并发异位骨化患者血清蛋白,寻找差异表达蛋白,筛选蛋白质标志物。方法收集2009年8月～2012年3月14例髋关节置换术后患者血清,以髋关节置换术后并发异位骨化（heterotopic ossification,HO）记为HO组,以未并发异位骨化为正常组,蛋白质芯片联合表面增强激光解析离子化飞行时间质谱（SELDI—TOF—MS）技术检测分析两组蛋白质表达谱,寻找差异蛋白。对每个质荷比峰值进行Wilconxon秩和检验,筛选P〈0．05的差异蛋白质峰。结果检测到154个高质量质谱蛋白质峰,其中质荷比为2748的蛋白点的峰值较正常组明显下调,匹配蛋白质为“一2一HS糖蛋白B链（Alpha一2一HS．glycoproteinchainB,AHSGB一链）。结论AHSGB一链的低表达与髋关节置换术后并发HO密切相关,可能为HO的敏感蛋白质标志物。     

Extensive osteolytic cystlike area associated with polyethylene wear debris adjacent to an aseptic, stable, uncemented unicompartmental knee prosthesis: case report

We present the case of a patient who after uncemented unicompartmental knee arthroplasty developed a large osteolytic cystlike area in the lateral aspect of the tibial metaphysis, contralateral to a well-fixed tibial component at revision surgery. The lesion contained fibrotic soft tissue, evidence of a foreign-body giant cell reaction and polyethylene particles, but no metal wear debris, infection, or malignancy. This case demonstrates that there is a direct communication between the joint cavity and the cyst.     

Lower extremity gait kinematics outcomes after knee replacement demonstrate arthroplasty-specific differences between unicondylar and total knee arthroplasty: A pilot study

BackgroundThe aim of the present study is to compare sagittal gait kinematics of ankle, knee and hip joints between subjects with unicondylar and total knee arthroplasty and age matched healthy controls. Since unicondylar knee replacement is a less invasive procedure, which more closely preserves knee joint anatomy, we hypothesized that one year post unicondylar knee arthroplasty patients would demonstrate more normal gait patterns than patients with total knee arthroplasty.Research questionDo unicondylar and total knee arthroplasty patients display similar gait kinematics one year after surgery?MethodsFourteen subjects (8 posterior stabilized and 6 medial unicondylar knee replacements) that were one year post surgery, and 6 healthy control subjects underwent a 3D gait analysis and a physical examination (range of motion, muscle strength). Statistical parametric mapping was used to compare gait kinematics of the lower limbs between groups. Additionally, differences in peak angles and clinical outcomes were assessed using a one-way ANOVA between subjects analysis.ResultsBoth knee replacement groups showed reduced knee flexion range of motion and reduced muscle strength at the operated leg compared to the control group. Subjects with TKA demonstrated reduced knee flexion at loading response and midstance of the gait cycle. Both UKA and TKA demonstrated significantly less knee flexion during swing.SignificanceThe results of this study demonstrate arthroplasty-specific differences in muscle strength, range of motion and gait kinematics of the lower limb one year after knee surgery. Future planning of post-surgery follow-up should addresses these arthroplasty-specific weaknesses and gait deviations.     

Patient-reported outcome after fast-track knee arthroplasty

Purpose

The purpose of this study was to describe patient-related functional outcomes after fast-track total knee arthroplasty and unicompartmental knee arthroplasty. Furthermore, we wanted to assess physical areas where an additional need for rehabilitation could be identified, and finally, we wanted to describe the association between physical function, health-related quality-of-life (HRQOL) and patient satisfaction.

Methods

The study consisted of 211 consecutive fast-track patients of which none received additional rehabilitation beyond an instructional exercise plan at discharge, which was adjusted at one outpatient visit. The patients filled in 3 questionnaires (EQ-5D, SF36 and a disease-specific questionnaire) at 2 time points before the operation and 2 time points after the operation. The observed results were compared to normative population data for EQ-5D and SF36.

Results

Four months after the operation, the patients had reached a HRQOL level of 0.82 (SD 0.15), which was lower than the background population norm of 0.85 (n.s.), whereas it equaled the population norm at 12 months (n.s.). For SF36, physical function was 62.8 (SD 23.0) at 4 months and 66.2 (SD 24.1) at 12 months, which was lower than the background population norm of 75.0 (P < 0.01). No or mild pain and good function ability were associated with high HRQOL and patient satisfaction at follow-up.

Conclusions

There seems to be an additional need for postoperative rehabilitation after fast-track total knee arthroplasty and unicompartmental knee arthroplasty regarding early functional outcome. No or mild pain and good functional abilities at 4 months are associated with high HRQOL and patient satisfaction at 4- and 12-month follow-up.

Level of evidence

II.     

总胆汁酸及前白蛋白等指标诊断肝硬化及肝肿瘤的应用价值

 目的 调查血清总胆汁酸(TBA)等指标在肝硬化及肝肿瘤患者中的水平,讨论其临床应用价值.方法 163例分为三组:肝硬化代偿组56例,肝硬化失代偿组62例,肝肿瘤组45例;对照组51例,为心、肺、肝、肾功能均无异常的健康体检者.所有受试者均空腹抽血检测以下指标:血清总胆汁酸(TBA)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、胆红素、前白蛋白(PA)、白蛋白(ALB)、胆碱脂酶活性(CHE)、总蛋白(TP)、超敏C反应蛋白(HS-CRP)、补体C3.比较患者组与健康体检者化验指标的差异.结果 (1)疾病组血清总胆汁酸(TBA)均显著升高(P<0.01),失代偿组水平最高.(2)转氨酶均升高(P<0.01),代偿组以谷丙转氨酶(ALT)升高显著;而另两组以谷草转氨酶(AST)升高更为明显.(3)前白蛋白(PA)均下降(P<0.01),三组间无显著性差异(P>0.05).白蛋白(ALB)、胆碱脂酶活性(CHE)的水平按代偿组、失代偿组、肝肿瘤组依次降低(相邻两组间P<0.05).(4)肝硬化失代偿前后补体C3水平均显著下降(P<0.01),失代偿组下降更为明显.结论 在肝硬化、肝肿瘤患者中,血清总胆汁酸(TBA)的检测较其他指标更为敏感.前白蛋白(PA)更为敏感地反映肝脏合成功能的损害程度.补体C3的改变与肝硬化病情密切相关.HS-CRP与病情进展高度相关,尽早控制炎症有利于疾病的治疗.总胆汁酸(TBA)等指标的联合检测有利于对病情的分析和诊治.     

CPM机锻炼在人工全膝关节置换术后早期康复训练中的效果评价

目的探讨CPM机持续被动锻炼在人工膝关节置换术后早期康复训练中的应用及效果评价。方法对92例人工膝关节置换进行早期CPM康复训练指导并进行随访。结果本组所有病例在术后7～14 d在步行器的帮助下步行,膝关节自主屈曲活动均达到90°以上,伸直0°,出院2～3个月后生活完全自理。结论对膝关节置换术后患者应用CPM机进行功能康复训练指导,可以有效防止关节粘连,使膝关节早日恢复良好状态。